Mud and Waterfalls - The Catlins

This weekend was our anniversary weekend and to celebrate we ventured out into the Catlins. This long stretch of rural land, along the Southern Scenic Route, is filled with many tramps and side attractions.

We were certainly off season during our visit but an interesting experience it was. The scenery was beautiful. Our first stop was Curio Bay where one can see Hector Dolphins (the world's smallest dolphin) and yellow eyed penguins (the world's rarest penguin). We luckily saw none of them but we still were able to enjoy the petrified forest and rugged coastline. It was an ethereal scene with a misty coast and the tide rising along the shadows of Prehistoric past. You could see some of the outlines of Jurassic aged trees in the beach, captured in silica stone. We were able to walk along it and I curiously touched the surface of this rock amazed at the years between us.


We next headed to Mclean Falls for a short tramp through dense rain forest. The trek took us through lush green jungle, and ended with a spectacular view of a young waterfall where you could still see the stratification of different rock layers. We were able to climb quite close to the waterfall itself and were astounded by its grandeur.

After this we went to Purakaunui Falls, which are supposed be renowned as the most photographed waterfall in New Zealand. They were beautiful but somewhat disappointing after Mclean Falls. However, the trail was very short which was a plus during this muddy season.

So speaking of mud, our next tramp was off to Picnic Point in Papatowai. This misty beach is a site where you can free dive for Paua, a very large sea snail found in a shiny shell, that is if you don't mind swimming with the great white sharks which also share the waters.

We were walking along the beach line, and then found this trail called King's Rock. We followed this trail that was in a clear state of disrepair. Obviously winter is not a tourist season. While we walked, Paul made up lots of fairy tales about King's Rock to convince me this was a good idea.

But the further along we got the larger the debris that was found blocking the trail. Whole trees fell across the path; mud pits became quite deep as Paul nearly lost his shoe in one of them. Then the trail seemed to dead end at a fenced cow pasture. We stared at the sign in front of us for a couple minutes, which told us to follow the marking posts THROUGH the pasture. So over the private fence we went, mucking our way through well trodden mud. We spied a number of cows and calves mowing the pasture. As we continued we hoped that neither of us was going to twist an ankle in all these divots in the ground. We finally made our way to the beach, and there sat this huge hunk of rock covered with bushes. Well that's it, it was a rock. We also realized this WAS NOT a loop trail, despite what Paul thought. Arggh.

So back we went through the pastures, over the fence, around the downed trees, shoes thick into sticky mud and finally did we return to the beach at Picnic Point. Luckily there were many native sponges strewn along the ground and we used them well on our shoes to wash off the mud.

After that we decided we had finished tramping for the night and went to the Hilltop Accomodations. In true New Zealand fashion we checked our selves in to our own suite as the owners were not around. It was a quaint hostel, with a great view of the surrounding area. Yes, more sheep dotting the landscape. Gotta love your sheep. We had our dinner of chicken soup and instant noodles. Then off to some well deserved rest and showers.

The next day, we attempted to tramp a bit more. Our first attempt was Possumer's Trail (yes they hunt possum and make them into coats here). This started out well enough, but progressively became more and more like a swamp. We discovered that a good sign of a poorly kept trail is when there is a LARGE tree covering up the trail and mud that you can swim in. I was walking in front of Paul when at the end of one of the boardwalks there was some fairly wet looking ground. I attempted to test it out with my toe, but immediately found myself sucked in foot deep. We later tested it with a stick and I probably could have fallen in to my knees. After the third or fourth set of these mud pools we decided to turn back.

We took the Old Coach Road instead, and enjoyed a trail that followed the coastline. Paul chased some wild cows along the way, no kidding. He brought out his whipping stick and told me he knew how to use it. Hmmm... I later found him digging at the beach sand telling me he was trying to catch the clams. I quickly did a mini-mental status survey, but he seemed to generally be all there, or as much as he usually is.

After this quick tramp, we headed off to Claire's, who is a fellow doctor that works with me at the clinic. She's a Scottish transplant, and her husband who's a native Kiwi. They own a small farmlet in the area. There they have chickens, lambs, cows, and horses. They grow their own vegetables and plan on becoming more self sufficient by canning them. Claire's husband also hunts deer, fishes, dives with paua, and is raising trees to sell for timber.

We had a marvelous home cooked meal and good company. Then we went home.



New Zealand Travel Tip #1: Avoid smooth mud patches on trails (because it is liquid) or wear bigger boots.

Reflecting After a Sad Day...

So practicing for a bit in New Zealand has been eye-opening, horrifying, and refreshing all at once. There is such a vast difference, micro-cosmically speaking, in the medical culture, but also in the culture as a whole. I think that, particularly, coming from large, urban health centers on the East Coast of the US (with such giants in the world as Harvard nearby) has made this transition somewhat dramatic for us. The levels of what are possible, and, even more so, what is expected, are just light-years apart.
We have found the people of New Zealand to be exquisitely pleasant after dealing with, not just patients, but often people in general, in the US. It may just be a small town vs big city phenomenon, or perhaps just us being taken out of the Eastern seaboard where we settled into the relatively cool and distant culture that never quite fit us. But the base level of civility is wonderfully refreshing here. Oh sure...there are certain problems endemic to small towns: a fair bit of drunken brawling, gossiping, etc..., but, generally speaking, we find ourselves somewhat overwhelmed by the friendliness here, sometime even annoyed by it, as we've become so jaded to nice people.
The way that this culture spills over into medical practice has also been nice to see. It's so rare to meet a patient in the US...or at least it seem so...that has pain anything less than a 10 on a scale of 1 to 10; quite often the scale is misunderstood to go on upward from 11 to millions out of 10. And the perception, reasonably or not, is that this pain should be gone. Always. In fact, the US consumes >90% of the worlds hydromorphone supply (roughly 7-8x the potency of morphine). Everyone is always in pain, which may be true...but it wears you out to constantly be dealing with it...it taxes ones compassion. Here, you witness grown men trying to hold back tears after they've had horrible accidents, and their pain is 6 of 10. It really invokes a soft spot in your heart and actually increases the capacity for care to see what is clearly under-reporting. It's just so refreshing to treat pain knowing that there isn't an attempt to get a high off the treatment.
Along with this less ambiguous feeling about treating people, there is just so much more gratitude for what is done, even if it doesn't solve everything. There seems to be an almost baseline assumption that, of course, the doctor is trying their best to help. And that makes all the difference in the world. That, perhaps, is the most gratifying thing. Even in day to day relationships, this seems important. What good relationship doesn't start with the assumption of best intentions? Medicine in the US seems, not always but often, much more antagonistic, and, to quote Radiohead, "It wears me out." I pulled someone's fingernail off that would likely never grow back, and stitched the remaining stump of a finger back together, to try and avoid infection. In the US, there would have been constant second guessing, demeaning comments, and demands to see a specialist who only deals with the fingernail of that finger and hand (granted, I wouldn't have been pulling off fingernails in the US). Instead, I was thanked...and profusely.
The gratitude even extends to when nothing can be done beside making someone comfortable. I love end-of-life care. It is often a wonderful and beautiful thing. But particularly, I think, in large, advanced, urban centers there is this misconception that people are not suppose to eventual die. And if you're the bearer of information that there isn't a cure or a solution or whatever, there is an immediate distrust, and quite often...an unrealistic expectations that the 90 year old, demented patient with no functional organs left should be kept alive on life support because "they're a fighter", which most people are, even though no one would think to torture their pet dog in that way. There seems to a more realistic understanding of life here...that it eventually ends, but that that can still be done in the best way possible...that there is pain, and sometimes it doesn't go away entirely, but you can still do things with your life...that yes, there might be something more that could possible be done, but it's not likely to do good, so you don't have to choose to do it.
It can be horribly frustrating here when you have a healthy 80 year old that should be able to have a surgery that would make the next 10 or 15 years of their life better and no one will do it no matter how much you yell at them. Even more so, it's frustrating when you see younger people hurting or dying because there isn't a specialist available, because there just aren't enough of them, or you can't get them to one on-time for such stupid reasons as the roads a snowed over and the ambulances and helicopters are running. But by and large, it is refreshing to see that people can get on with life even when a doctor didn't make everything better for them...and even still find gratitude for what that doctor did do.

Dolamore Park and Bacon

We made a recent visit to one of the local parks in Gore - namely Dolamore Park. We were surprised to find that it was quite an expansive area to explore. Great for day hikes. Multiple 1-3hr tramps. We decided to take on Whiskey Creek and then Hidden Valley trail. The Whiskey Creek Trail was a heavily forested and prolonged uphill track with lots of large trees, virtually empty of any people. We were reminded of the Lord of the Rings. Paul said he would be Faramir but wished to be more Sam Gamgee-like, while Zhiling ventured more towards Bilbo-esque qualities. In terms of evil characters Paul was Saruman, and Zhiling was the Balrog. Awesome.

The scenery quickly shifted to Jurassic Park as we ventured into Hidden Valley. The trail narrowed and sometime disappeared, and heavy undergrowth of prehistoric ferns obscured the land. What trail remained was muddy and steeply descending. Paul fell on his ass several times. Zhiling watched as she let him lead (and perhaps relied on him ..very few times.. to help carry her across muddy ways). It was entirely gorgeous.. the forest.. not the falling.

Fortunately our tramping was well timed, and we got home before the snow began that day. The weather here is truly schizophrenic.

On a side note, they always talk of the mutton in New Zealand, and we found that dairy is actually more prevalent. But the true treasure of New Zealand (per Paul) is B-A-C-O-N. It started with an innocent pack of bacon bought by our future employers on our arrival. But soon the Baconlust was upon Paul; now nightly as Zhiling sleeps, Paul arises from slumber with the hunger that only Bacon can satisfy. Sultry fatty strips, fried to gorgeous salty perfection. The fat-engorged thick slices melt slowly in the mouth, taking on the consistency that they will remain in the arteries (no wonder everyone here has hypertension and heart disease...totally worth it). The Baconlust is strong...Mom and Dad, when you travel down here in January...bring silver bullets.

Welcome to New Zealand

Paul and I are settling in to our new place in Gore, New Zealand. It's been a fairly pleasant experience all around. After a frustrating flight - which included plane delays, lost luggage, and possible engine failure we made our way across the Pacific in once piece and got picked up by the CEO of the hospital at Invercargill. He took us out for dinner, and drank some beer. And we even got a fruit basket and a bouquet of flowers to welcome us as we arrived at the motel that we would be staying at for a couple days.

Gore is a small town of around 12-15,000 people. Many people here have jobs in the farming and/or dairy industry. The one thing I remembered learning about New Zealand was the greater number of sheep to people ratio in this country. And now seeing the huge rolling hills, sheep herds dotting the scenery it is a beautiful truth out here.

The weather is a bit odd to get used to as its winter here, and basically its kindof like Seattle where it just keeps on raining, snowing, or even hailing intermittently but then the sun pops out, and everything dries or melts within a couple hours.

We got set-up in a furnished house just about 4-5 blocks away from the hospital. So just a 10 minute walk to work. It's like grandma's house with multiple random knick knacks and 70's furniture. All the houses in the Southland seem to be notorious for the lack of central heating as it hasn't seemed yet caught on here. So we have multiple space heaters throughout the house to keep us warm in the evenings.

Paul and I have become meatatarians lately as the grocery shops and prices here are likely reflective of our areas industry. Beef, lamb, cheese, and mmm... bacon are quite plentiful. Vegetables are horrifically expensive at least during these winter months, and we saw tomatoes priced as high as $17.00 per kg. Ouch! Besides that we've eaten a lot of Cadbury chocolates, as one of the primary factories and birth centers of Cadbury started in Dunedin, NZ just about 2 hours from here.


Oh yes and we are working. Paul and I are working at the same health facility. The community hospital along with the clinic are attached to each other. The hospital itself is a 16 bed hospital with an emergency room (known as the A and E, accident and emergency) center. The clinic I'm in has been around for ages, though recently acquired by Gore Health from the previously established Dr. Park, who as gossip goes was a 'Workhorse' and his patients grew old with him so large geriatric population.

Currently the GP's at the health center are somewhat transient as Gore Health is still establishing their GP practice. 3 doctors currently at the practice, a South African doctor who's been in practice for 40+ years from Pretoria, but came out here as a semi-favor to the health center to maintain our numbers for patient visits, a previous Scottish locums now NZ resident who's part time, and myself.

So we're a multicultural crew with multiple accents. What's been nice about the Health center is the support staff are well skilled and helpful! My patient numbers have definitely doubled up to 23 patients per day though paperwork is definitely a lot less.

Medical issues i've seen include lots of group A strep, they don't have rapid strep tests here. Saw this gal who had a scarlatina rash but no sore throat or URI symptoms but ended up having sky high ASO titer who would have known. Paul's pulling contaminated nails out of a farmer's hand who got it caught between a cow horn and a fence, seeing acute abdomens, and freaking out that he'll see a pregnant woman or acutely ill child in the middle of the night (but if you're a doctor, you can do anything, right?).

Paul and I are planning several tramping (hiking) trips around the area. We've been to Bluff the oldest town in New Zealand, ate raw oysters, hiked along the southern coastline, visited the Cadbury factory in Dunedin(saw 1 ton of liquid chocolate fall 2 stories down a silo, known as the chocolate waterfall), and accosted goats to take their pictures along the sides of country roads after hiking on a nearby mountain.